Good idea to leave a practicum?

[NP112]

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I am currently in a practicum placement that is requiring me to do 24+ hours per week of work to do the work well. I have been cutting corners to stay under this number, but am not satisfied with the work I am putting out. I have already had a conversation with my supervisor about lowering the workload. I used to be turning out 14+ page reports weekly on top of seeing 5 patients, charting, supervision, and session prep. My DCT has recommended I have another chat about lowering my hours to around 15 per week. In the change that my placement supervisor is unwilling to do so, would I have a justifiable reason to leave this placement? I know they ask whether you have left a placement on the APPIC application, but am not sure ruining my mental health and neglecting other research projects for the next 3 months is worth it.

 

[affectiveH3art]

I am currently in a practicum placement that is requiring me to do 24+ hours per week of work to do the work well. I have been cutting corners to stay under this number, but am not satisfied with the work I am putting out. I have already had a conversation with my supervisor about lowering the workload. I used to be turning out 14+ page reports weekly on top of seeing 5 patients, charting, supervision, and session prep. My DCT has recommended I have another chat about lowering my hours to around 15 per week. In the change that my placement supervisor is unwilling to do so, would I have a justifiable reason to leave this placement? I know they ask whether you have left a placement on the APPIC application, but am not sure ruining my mental health and neglecting other research projects for the next 3 months is worth it.

Is this a beginning prac/adv. prac? A clinical or assessment experience with 5 testing clients a week? I often worked more than 20 hrs a week in prac and in 4th and 5th year did about 35 hrs so I suppose it depends. It does not sound like an intense overwhelming caseload but I do not know your specific situation or other responsibilities you have. I think it's worth a learning experience to challenge yourself for 3 more months. You ultimately want to be able to be efficient and produce high quality work - but if it's too early, you may burn out.

 

[AcronymAllergy]

My knee-jerk response would be to try to stick it out, but I would have the same questions as affectiveH3art. Our practica defaulted to somewhere around 20-30 hours/week if I'm remembering correctly, especially the more advanced practica when we had less coursework to worry about (but more research and dissertation activities). I would say a 14+ page report per week is a bit much, though, particularly for a practicum student. But my personal opinion is a 14-page report is a bit much in most (non-forensic) settings.

 

[erg923]

I am currently in a practicum placement that is requiring me to do 24+ hours per week of work to do the work well. I have been cutting corners to stay under this number, but am not satisfied with the work I am putting out. I have already had a conversation with my supervisor about lowering the workload. I used to be turning out 14+ page reports weekly on top of seeing 5 patients, charting, supervision, and session prep. My DCT has recommended I have another chat about lowering my hours to around 15 per week. In the change that my placement supervisor is unwilling to do so, would I have a justifiable reason to leave this placement? I know they ask whether you have left a placement on the APPIC application, but am not sure ruining my mental health and neglecting other research projects for the next 3 months is worth it.

Unless you are doing forensic evaluations 14 page reports are very likely a waste. Shorten the report.

 

[NP112]

Unless you are doing forensic evaluations 14 page reports are very likely a waste. Shorten the report.

I wish I could! My supervisor is a fan of including everything and then some.

 

[NP112]

Yes, advanced practicum. Also have TAship, qualifying examinations in summer etc. etc.

 

[WisNeuro]

Yeah, I'm with others, I only write reports in the double digits for legal cases. Clinical reports top out at 5 pages. And those are the complex ones.

 

[NP112]

I agree with shorter reports. Wish it was more of a norm, even for ADHD, LD.

 

[erg923]

I wish I could! My supervisor is a fan of including everything and then some.

I agree with shorter reports. Wish it was more of a norm, even for ADHD, LD.

I would ask him/her about this. Seriously, Do it politely and respectfully. But try to understand if this is just about them and their personality, or some legitimate nuance to their work in that setting? Then try to figure out if this benefits the supervisor (their workflow, efficiency, time management, billing/productivity, patient access, clinical reputation, etc.), as well as the patients and referral sources you serve. Or, if it hurts them in some way? Or, if there is no measurable benefit by doing 14+ page reports? That would be interesting. Again, I am not kidding. "Consumer-oriented" report writing is something that needs to be taught/mentored in order to keep Psychological Testing evaluations relevant and useful in the current health care space.

Psychological assessment reports are only as useful as how the information is conveyed and disseminated to the audience. If you are babbling, hemming and hawing, and my personal favorite... trying to educate everyone and their mother about what each and every test you gave is and what is measures...you guys are wasting your time. No one reads this. Psychological assessment should not turn into a creative writing class. Nor is it a dissertation.

You want to help the referral source treat/plan treatment the patient. That's literally the only thing you need to be doing in a clinical exam. You do not have to fully explain or understand every single thing that is happening or has happened in the past. And you certainly don't want to "muddy the waters" with overwhelming amounts of information/background and/or too much speculation. A laundry list of 20 different treatment recommendations is not needed either.

 

[beantownpsych]

Honestly I think the hours are not unreasonable (many advanced practicum require 20-30 hours of work even in research heavy phd programs). 14 page reports, on the other hand, is ridiculous.

 

[ccool]

As a fellow grad student, I feel for you. Although there is the extent to which we can exert our autonomy and advocate for ourselves/our clients, we are ultimately bound to our supervisors’ authority... for liability purposes and for all the weird power and impression management stuff.

The central question for me is what was the original expectations of the position or “contract” that you agreed upon before you started.. presuming that you made a free choice to take this position?

If you accepted this position with the understanding that it was a 20-24 hour one with the duties you describe, I’d say there’s really not much room for you to do any more than you have.

If it was supposed to be a 12-16 hour one, I think you can certainly point to that and suggest ideas or ask for ideas to reduce your workload to fit within the previously-agreed upon parameters...especially if this is an unpaid position. Establishing and maintaining boundaries are important. And from a capital and labor perspective, I find that doing free labor, as in 8 extra, not-previously agreed upon hours is not acceptable... not only for the principle but also because that’s 8 hours not going to fulfilling your needs. If you truly are doing more hours than were agreed, have been since you started and have already had this conversation, it seems unlikely to me that things will change... but it may be worth it to come at it from this angle and perhaps be more transparent about the toll it’s taking on your health...if you have that kind of relationship with your supervisor.

Regardless, I ultimately agree with everyone else to just finish the three months unless you are seriously concerned for your health and safety. Use this experience as a professional development opportunity to continue recognizing your needs and limits, being assertive, establishing boundaries, managing your time, and enhancing your clinical and report-writing skills. And then use all of that to move forward better in the future!

 

[NP112]

I would ask him/her about this. Seriously, Do it politely and respectfully. But try to understand if this is just about them and their personality, or some legitimate nuance to their work in that setting? Then try to figure out if this benefits the supervisor (their workflow, efficiency, time management, billing/productivity, patient access, clinical reputation, etc.), as well as the patients and referral sources you serve. Or, if it hurts them in some way? Or, if there is no measurable benefit by doing 14+ page reports? That would be interesting. Again, I am not kidding. "Consumer-oriented" report writing is something that needs to be taught/mentored in order to keep Psychological Testing evaluations relevant and useful in the current health care space.

Psychological assessment reports are only as useful as how the information is conveyed and disseminated to the audience. If you are babbling, hemming and hawing, and my personal favorite... trying to educate everyone and their mother about what each and every test you gave is and what is measures...you guys are wasting your time. No one reads this. Psychological assessment should not turn into a creative writing class. Nor is it a dissertation.

You want to help the referral source treat/plan treatment the patient. That's literally the only thing you need to be doing in a clinical exam. You do not have to fully explain or understand every single thing that is happening or has happened in the past. And you certainly don't want to "muddy the waters" with overwhelming amounts of information/background and/or too much speculation. A laundry list of 20 different treatment recommendations is not needed either.

Yes, definitely benefits the supervisor. They are 4+ months behind on report writing and I get the sense they are swamped. My DCT says to try and avoid going above 16 hours per week in practicum at most, and strongly suggests going above that if possible.

 

[erg923]

Yes, definitely benefits the supervisor. They are 4+ months behind on report writing and I get the sense they are swamped. My DCT says to try and avoid going above 16 hours per week in practicum at most, and strongly suggests going above that if possible.

So, um....yeah.....

4+ months behind on report writing?! I don't even know how that works? Some of your patients symptoms and situations are likely to shift significantly every few months.

Bottom Line:
Your supervisor needs to get their **** together! Or at least have a meeting with their boss RE company resources? Or at least learn to say (citing ethics code) "no!"

Either way...clinging to idiosyncratic and excessive report writing "rules" may be hurting them and patients (and YOU) in this scenario? Not helping anyone, no?

 

[PsychPhDone]

I am currently in a practicum placement that is requiring me to do 24+ hours per week of work to do the work well. I have been cutting corners to stay under this number, but am not satisfied with the work I am putting out. I have already had a conversation with my supervisor about lowering the workload. I used to be turning out 14+ page reports weekly on top of seeing 5 patients, charting, supervision, and session prep. My DCT has recommended I have another chat about lowering my hours to around 15 per week. In the change that my placement supervisor is unwilling to do so, would I have a justifiable reason to leave this placement? I know they ask whether you have left a placement on the APPIC application, but am not sure ruining my mental health and neglecting other research projects for the next 3 months is worth it.

Others may disagree, but if the expectation was 16 and you're closer to 24, and it's adversely impacting your other work or aspects of your life (including consideration that we're in a global pandemic right now and many of us are worn thin)...and you + DCT can't get it down to 16 hours...and this person is way behind on reports... I'd try to find something else. I am am n of 1 but I would not see dropping a practicum as a red flag on an APPI if the application were otherwise good. Sometimes things are a bad fit or life changes.

 

[beantownpsych]

Questions to consider:

1. How central is this practicum to your future career goals? If you want to go into neuropsych and this will be your only neuro practicum that would concerning. Same if this is your only VA experience and you are planning to apply to VA-based internships.
2. Are you going to need a LoR for this practicum?
3. Would your DCT support you leaving? If not, is your DCT be willing to advocate directly for you with the site/prac supervisor and tell them that you can only work X hours (if this is indeed the case and was the agreed upon contract).
4. Does leaving early impact your future practicum activities?
5. Do you need this practicum to check boxes you need for a competitive internship application? Diversity of experience, setting, population...

 

[ccool]

Others may disagree, but if the expectation was 16 and you're closer to 24, and it's adversely impacting your other work or aspects of your life (including consideration that we're in a global pandemic right now and many of us are worn thin)...and you + DCT can't get it down to 16 hours...and this person is way behind on reports... I'd try to find something else. I am am n of 1 but I would not see dropping a practicum as a red flag on an APPI if the application were otherwise good. Sometimes things are a bad fit or life changes.

I agree. I fully advocate taking care of you, whatever that means for your circumstances.

And with 16 being the expectation from your program and presumably the site, it may be worthwhile to get your DCT more directly involved in your (and maybe others’ ??) advocacy. For example, when students in my program were facing similar issues at sites, after much back and forth, my DCT eventually sent a broad reminder email to all sanctioned practica supervisors that the expectation was that students were not to exceed the specified hours and if there were any concerns as it relates to training or their relationship with the program to reach out to him to troubleshoot. It was overall effective.

If you don’t need this particular letter of rec and feel like you’ve gotten what you wanted from the experience, yea, do what you need to take care of you. If you give notice and close up all your things with grace, certainly they’ll understand.. even if they’re annoyed about dealing with the fallout on the business end.. but that’s their responsibility.

 

[psych.meout]

I wish I could! My supervisor is a fan of including everything and then some.

Yes, definitely benefits the supervisor. They are 4+ months behind on report writing and I get the sense they are swamped. My DCT says to try and avoid going above 16 hours per week in practicum at most, and strongly suggests going above that if possible.

I am currently in a practicum placement that is requiring me to do 24+ hours per week of work to do the work well. I have been cutting corners to stay under this number, but am not satisfied with the work I am putting out. I have already had a conversation with my supervisor about lowering the workload. I used to be turning out 14+ page reports weekly on top of seeing 5 patients, charting, supervision, and session prep. My DCT has recommended I have another chat about lowering my hours to around 15 per week. In the change that my placement supervisor is unwilling to do so, would I have a justifiable reason to leave this placement? I know they ask whether you have left a placement on the APPIC application, but am not sure ruining my mental health and neglecting other research projects for the next 3 months is worth it.

14 page reports, including extra things that may not be pertinent or helpful for the case/referrer, and the supervisor being over 4 months behind on reports? Is your supervisor an ECP?

 

[NP112]

14 page reports, including extra things that may not be pertinent or helpful for the case/referrer, and the supervisor being over 4 months behind on reports? Is your supervisor an ECP?

Yes, an ECP.

 

[NP112]

Questions to consider:

1. How central is this practicum to your future career goals? If you want to go into neuropsych and this will be your only neuro practicum that would concerning. Same if this is your only VA experience and you are planning to apply to VA-based internships.
2. Are you going to need a LoR for this practicum?
3. Would your DCT support you leaving? If not, is your DCT be willing to advocate directly for you with the site/prac supervisor and tell them that you can only work X hours (if this is indeed the case and was the agreed upon contract).
4. Does leaving early impact your future practicum activities?
5. Do you need this practicum to check boxes you need for a competitive internship application? Diversity of experience, setting, population...

Yes, all things to consider.

1. Not very. It's a private practice and I see myself going for VA positions. I am not neuropsyh (anymore) either. I have previous NP experience too.
2. No
3. Yes, my DCT is very supportive. Not of me leaving per se but is a great advocate.
4. Not to my knowledge. I have a few future practicum interviews coming up.
5. I wouldn't think so, it's a private practice and to my knowledge that is not anything special for internship apps. It is good for diversity of settings, having community health clinic and an AMC already under my belt.

 

[BuckeyeLove]

Is there a personality/characterological component to this supervisor? Not saying full blown, but do you get that a little bit of that feeling?

 

[AcronymAllergy]

With the additional information provided, particularly the parts about how far behind the supervisor is and that 16 hours max was the expectation (and is being reinforced/reiterated by your DCT), I don't think leaving the practicum early would be an outrageous idea. Ideally, you'd want to do so amicably. And to that point, I unfortunately don't see a conversation between you (a trainee) and your supervisor about their report length going well. In my mind, that's something that may need to come from a peer or their supervisor in order to realistically result in change. You could certainly talk with them openly about their report style in comparison to other practica and/or in relation to your workload, but directly questioning its utility may be best coming from peers or referral sources. But that's just my take.

Edit to say I agree 100% with @affectiveH3art (below) in that as a practicum student, it's not your job to have to help your supervisor catch up on reports. That's their issue.

 

[affectiveH3art]

Is this PP? I would have a discussion with the supervisor on boundaries as it is not your responsibility to help your supervisor to "catch up" with reports. You are in training so if they aren't respectful of your training needs (etc less reports, less of a caseload) then ask your DCT to speak to them about your request.

 

[NP112]

Is this PP? I would have a discussion with the supervisor on boundaries as it is not your responsibility to help your supervisor to "catch up" with reports. You are in training so if they aren't respectful of your training needs (etc less reports, less of a caseload) then ask your DCT to speak to them about your request.

Yes, PP.

 

[NP112]

Is there a personality/characterological component to this supervisor? Not saying full blown, but do you get that a little bit of that feeling?

No, do not really get that sense. Maybe depression.

 

[erg923]

No, do not really get that sense. Maybe depression.

That seem about right. Thats a daunting hole to dig out of unless you just stop seeing people for a few weeks. He is also just asking for a complaint to be filed from a dissatisfied patient/family waiting for him to do his job. And if he got one, it would likely result a some action.

 

[beantownpsych]

Yes, all things to consider.

1. Not very. It's a private practice and I see myself going for VA positions. I am not neuropsyh (anymore) either. I have previous NP experience too.
2. No
3. Yes, my DCT is very supportive. Not of me leaving per se but is a great advocate.
4. Not to my knowledge. I have a few future practicum interviews coming up.
5. I wouldn't think so, it's a private practice and to my knowledge that is not anything special for internship apps. It is good for diversity of settings, having community health clinic and an AMC already under my belt.

Given those answers I think it makes sense to leave (do as much as you can to leave on good terms and make sure your DCT is fully on board!) At least in my internship program (AMC) we don't care about PP experience.

 

[Therapist4Chnge]

Yeah, I'm with others, I only write reports in the double digits for legal cases. Clinical reports top out at 5 pages. And those are the complex ones.

Same. Clinical reports can sometimes hit 6 pgs, but 4-5 is typical. Forensic are nearly all double digit. I haven't hit three digits yet, though that may take awhile.

 

[Justanothergrad]

Yes, definitely benefits the supervisor. They are 4+ months behind on report writing and I get the sense they are swamped. My DCT says to try and avoid going above 16 hours per week in practicum at most, and strongly suggests going above that if possible.

If your DCT is trying to limit your practicum hours, they could also speak to the supervisor if your efforts aren't successful. This isn't entirely your responsibility - the program shoulders some of the management of practicum responsibilities. I would encourage you to talk to the supervisor again about ways to shorten hours

 

[PsyDr]

In my experience: if you have to ask, it’s not a good idea. Often fun, though.